How Effective is an RFP (Request for Proposal) when Selecting an EMR System?

Wednesday, 14 May 2008 04:00
Dr. Hazem El-Oraby

In theory, the RFP sounds like a good idea for a medical practice to 'sort out' 3 or 4 short listed vendors who may be in the running to provide a system to that practice. However, how does a busy physician create an RFP that is meaningful and will provide the ability to compare apples with apples when making the short list decision? Does the average physician who is seeking an EMR have the ability to read the RFPs and interpret the answers appropriately? How many RFP responses (of multiple 100s of pages) are simply scanned and set aside as the physician looks for easier ways to identify a potential EMR vendor?

Alan Brookstone from CanadianEMR discusses this issue...

An RFP is is an invitation for suppliers, through a bidding process, to submit a proposal on a specific product or service (Wikipedia). The RFP is becoming more commonplace in Canada as a way for regional health authorities, provincial governments, large organizations and groups of physicians to request information from an EMR vendor in order to select the most appropriate EMR system for that organization or medical practice. These documents can be quite onerous to complete (particularly in the situation in which there is a large provincial procurement of EMRs), however they are complex documents and may be 100 pages or more once completed.

One of the best ways to prepare an RFP is to describe what you are seeking in an EMR. In other words, describe your practice in simple language and what you are seeking from a business perspective. For example if your practice is primarily counselling based and you need a system that allows the ability to capture narrative notes, you may require an EMR that has an integrated speech recognition capability. There are many variances on this theme and too numerous to mention here. The point that I would like to make is that it is extremely difficult (without a great deal of experience) to develop an RFP document that is easy to complete and then interpret. It takes time and effort to prepare an inventory of your needs and then clearly define these in a document. How much time does the average physician have to put in this much effort?

In fact, it is a double edged sword. If a physician prepares a customized RFP, the likely result is that the quality of answers returned by the selected vendors will better help to inform the decision making. This requires a great deal of effort on behalf of the vendor as they have to customize the answers to the RFP to ensure that they are accurate and appropriate. On the other hand, a physician may obtain a standard RFP document (which could include detailed technical requirements) and may simply forward this document to the short-listed vendors in the hope that it will be appropriate. If the document is in a standard format, the vendor may have already responded to a number of similar RFPs and may then just copy and paste answers to the same questions from one document to another. At the end of the day, a great deal of time and expense still goes into preparing the response to the RFP.

It is my gut sense that we are getting caught in a RFP hurricane and despite the energy being expended both by the vendors and the physicians, we are not much further ahead in making calculated and appropriate decisions as to choice of EMR systems.

There is another downside to the increasing numbers of RFPs. Vendors have limited resources and must divide these up between sales, support and product development. If the number of RFPs continues to increase unabated, vendors will have to dedicate an increasing proportion of internal resources to respond (if this is the only way to win a client). Other areas of the business will suffer, including the resources that should be dedicated to product development and support. We may end up with vendors who have significant capability to respond to RFPs, but little else in terms of resources to support existing clients and continue to improve their product. This is not a good thing!

Perhaps it is time to re-evaluate our growing dependency on RFPs and look for more effective ways to evaluate and select EMR systems?

If you went through an RFP process in selecting your EMR, was it a useful approach? If you had to select an EMR again, would you go through an RFP or use some other mechanism? How important was a reference from a trusted colleague in helping you make a decision? Do you think we should continue to use RFPs to select EMRs and if so, how do we make the RFPs useful and not overwhelming for the vendors that have to dedicate resources in many different areas?